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GI Flashcards

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1
Q

dysphagia causes

A

anasthetic, neuro defects, oesophageal tumour

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2
Q

saliva contains

A

amylase, Iodide, alkaline, calcium, lysozymes

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3
Q

secretions of salivary glands?

A

parotid - serous
sub max - mixed
sublingual - mucus

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4
Q

saliva secretion cell

A

ductal side has NaKATPase and HCO3-Cl antiporter. ECF side has Na-KATPase, KCl symporter, and Na-H antiporter

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5
Q

stimulated saliva and resting properties

A

stimulated - increase volume, hco3, enzymes, more hypotonic

resting - slightly alkaline

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6
Q

sympathetic and PS innervation of salivary glands

A

symp - superior cervical ganglion (decrease volume)

PS - glossopharyngeal (increase volume)

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7
Q

swallowing process

A

bolus to pharynx then pressure receptor in palate. Glottis closes, larynx lifts, resp inhibited

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8
Q

solids and liquids dysphagia. or solids then liquids

A

solids and liquids - motility problem

solids then liquids - mechanical obstruction

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9
Q

what is achalasia

A

failure of smooth muscle to contract e.g. upper oesophageal sphincter

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10
Q

components of lower oeso sphincter

A

+ve intra-abdo pressure, gastric rugae, acute angle, right cruz of diaphragm

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11
Q

gastric cells and secretions

A

Neck - mucus and HCO3
parietal - HCl and intrinsic
Chief - pepsinogen
G cell - gastric

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12
Q

cephalic, gastric and intestinal phase

A

cephalic - CNS stimulates acid
gastric - neutralisation, peptides and distention stimulate gastrin
intestinal - decrease pH and peptides stimulates secretin secretion which inhibits gastrin.

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13
Q

Where secretin from. what stimulate and its action. CCK too

A

from S cells of duodenum
stimulates HCO3 from pancerase and bile from liver
stimulated by low ph in duodenum

CCK from duodenal APUD cells. stimulates enzymes from pancreas and gall bladder and stim by FAs and AAs in duodenum

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14
Q

what causes atresias, stenosis, exampholos, gastroichisis

A

atresia - failure of anal membrane to rupture
stenosis - failure of recanalisation usually in duodenum
exampholos - gut and peritoneum herniates through umbilical cord
gastroischisis - failure of abdo wall to close, no sac

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15
Q

action of obliques

A

fleex trunk, rotate, compress and support abdo viscera

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16
Q

what is divariation recti and ectopia cordia and meckels

A

DR - widening of linea alba
ectopia - heart outside thoracic due to failure of ventral mesoderm
meckels - 2 ft from ilieocecal valve, gastric or pancreatic tissue, 2 inches

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17
Q

referred pain from cardic, gastric, duodenum, gallbladder, hepatic, retroperitoneal

A

cardiac - chest, neck, left shoulder
oesophagus - epigastric
gastric - back
duodenum - epigastric or umbilicus
gallbladder - right hypochondriac, R lumbar and R shoulder
hepatic - epigastric, R hypochondriac, R neck shoulder and back
retroperitoneal - back pain

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18
Q

diaphragmatic irritation causes

A

spleen, ectopic pregnancy, perforated ulcer

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19
Q

borders hasselbachs triangle

A

inguinal ligament, inf epigastric artery and vein, rectus sheath

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20
Q

inguinal canal borders

A

ant - internal oblique fascia
post - transversalis fascia
inf - inguinal ligament
sup - aponeurosis of obliques

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21
Q

which strangulated more inguinal or femoral

A

femoral

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22
Q

presentation, treat gastritis

A

presents - GORD. dyspepsia, epigastric pain, lying down and hot drinks worse
treat - lose weight, decrease alcohol and fatty foods. Amoxicillin and clarithromycin and omeprazole. Endoscopy

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23
Q

symptoms of gastric and duodenal ulcer. treat?

A

gastric - worse at night, worse when aeating. relieved with antacids. N&V. weight loss, haematemssis. treat with clarith and amoxici and omeprazole

duodenal - better when eating. delayed pain when acid secreted into duodenum

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24
Q

where are the stomach cells found? stomach histology

A

columnar cells with glands.
cardia - G cells
Fundus and body - neck, parietal, chief cells
pylorus - neck and g cells

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25
gastric vsculature
see book | coeliac trunk, gastroepiploic, R L short gastric, proper hepatic, gastroduodenal, splenic
26
drainge of gastric and gastroeipoloic
gastric into hepatic | gastroepiploic into superior mesenteric
27
properties of chyme
hypertonic, acidic, partially digested
28
components of liver bile acid dependent and independent
dependent - cells lining canalliculi secrete. cholesterol, bile acid (e.g. chenodeoxycholic acid) and pigments independent - cells lining bile ducts. alkaline juices
29
describe how bile acid recycled
reabsorbed in terminal ileun post bacterial conjugation and then back to liver
30
gall stones symptoms
right hypochondriac pain, radiate to back or R shoulder, N&V, fatty meal = worse
31
endocrine pancreas secertionsq
alkaline juice and enzyme (chymotrypsinogen, trypsinogen, carboxypeptidase, amylase, lipase)
32
what is cholecystatis and symptoms
cystic duct obstructed. fever, oedema, increase WCC,
33
what is biliary cholic and symptoms
biliary duct obstructed. jaundice.
34
how duct cells secrete hco3
basolateral side - NaKatpase, naHantiporter | CO2 diffuses in then becomes HCO3 and then into lumen
35
how fats digested in guts
bile acids emulsify. lipases. FAs to unstirred layer. RME. made into TAGs then chylomicrons.
36
ligaments of liver
see book | triangular, coronary, falciform
37
biliary tree
see book | R L hepatic, common hepatic, common bile, cystic, pancreatic, sphincter of oddi
38
pancreas artery
splenic
39
pancreatic drainage
head - superior mesenteric | tail - splenic
40
adaptive and innate GI defences
adaptive - GALT | innate - acid, enzymes, mucus, peristalsis
41
achlorhydra symptoms
anemia (impaired iron absorption). increase infection from salmonella, shigella, cholera, H pylori
42
liver failure symptoms
hepatic encephalopathy, portal hypertension in cirrhosis
43
symptoms of portal hypertension and cirrhosis
caput medusa, varices, shunting, splenomegaly, palmar erthyema, dupuytrens, jaundice, anemia, flapping tremor,, spider naevi, ascites
44
investigations for hepatitis
jaundice, increase ALT (and AST), clotting increased
45
which is specifc to liver ALT or AST
ALT. L for liver
46
test for cholecystitis
bilirubin (conjugated) and ALP
47
prehepatic signs and causes
unconj bilirubin, increase LDH, anaemia | immune cause, infection (malaria), spherocytosis
48
hepatic jaundice signs and causes
increase ALT and AST, increase conj and unconj, clotting abnormal. cirrhosis, hepatitis B virus, alcohol, paracetemol
49
post hepatic signs and causes
increase conj, and ALP | gall stones, cancer, pancreatitis
50
alcohol disease on liver
fatty liver due to increase NADH leading to FA and TAG deposits. THEN hepatitis due to acetaldehyde. then cirrhosis and wernickes encephalopathy
51
causes of cirrhosis
wilsons, alcohol, hep B, autoimune
52
portal system anastamosis
oesophageal, rectal, caput medusae (para umbilical veins)
53
pancreatitis symptoms
shock, pain, vomiting, sepsis, increase insulin | chronic - malabsorption, decrease weight, DM, jaundice
54
glucose into cell
SGLT1 and then into ECF via GLUT2
55
what does large intestine absorb
vitamins and water
56
how calcium absorbed and taken into guts
absorbed by PTH via Vit D activation. Via facilitated diffusion into cell and then Ca-ATPase into ECF
57
explain how iron absorbed
iron + gastric acid then to transferrin and then RME
58
what does oral rehydration contain
glucose and na
59
how segmenting in intestine works
pacemakers fire quicker at stomach end than at large intestine end.
60
features of jejunum and ileum
jejunum - dark red, thick wall, no peyers | ileum - pink, thin, peyers
61
which one does smoking help with UC or CD?
UC
62
features of UC
continous, rectal involvement, gross bleeding, mucosal ffriability, pseudopolyps
63
CD and UC treatment
CD - corticosteroids, methotrexate, azathioprine | UC - same and colectomy
64
why baxcteria in gut good
vitamins, kill pathogens, MALT stimulate
65
what bacteria cause gastroentiritis
campylobacter, salmonella, listeria
66
what causes gingivitis and travellers diarrhoea
gingivitis - strep mutans | travellers diarrhoea - e coli
67
gastric cancer symptoms and appearances and spread
epigastric pain, vomiting, weight loss appearance - fungating, ulcerative, infiltrative spread - local, trans-coelemic (liver, peritoneum, ovaries), lymph
68
large intestine cancer cause
familial adenomatous polyposis, DCC gene
69
what is ileus, toxic megacolon and lead pipe colon
ileus - loss of peristalsis toxic megacolon - v dilated colon (IBS deterioratioN) lead pipe - severe UC. no haustra
70
small bowel colic symptoms and cuases
vomiting, distention, constipation, pain 2-3 mins | cause - adhesions, hernia, tumour, inflamm
71
large bowel colic symptoms and cuases
symptoms - vomit faeces, distention, consitpation,. pain 10-15 mins cause - hernia, cancer, volvulus

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